Abstract: Objective:To evaluate the efficacy, adverse reactions and survival of 137 metastatic soft tissue sarcoma pa -tients treated with MAID regimen as first-line therapy. Methods:One hundred and thirty-seven patients with metastatic soft tissue sarcoma were treated with MAID regimen chemotherapy with ifosfamide at a total dose of 8～10g/m2 in 4-5 days,adriamycin at a dose of 60mg/m2 on the first day and dacarbazine at a dose of200 mg/m2/d in 4-5 days. Twenty one days were regarded as a cycle and2-6 cycles were completed. The median cycle number was 4. Results: Four cases had com-plete remission (CR) (2.9% ), 13cases achieved partial remission (PR) ( 9.5% ), 88cases maintained stable disease (SD) (64.2%), and32cases had progressive disease (PD) ( 23.4%). The overall response rate (RR) was 12.4% and the disease control rate (DCR) was 76.6%. The progression-free survival (PFS) was 2-14months and the median PFS was5.00± 1.12 months. The overall survival (OS) was 3-19months and the median OS was8.00± 1.32months. The 3 month PFS rate was 56.9%, the 6 month PFS rate was27.2% and the one year PFS rate was7.8%. The3 month OS rate was 100 .0%, the 6 month OS rate was 41.5% and the one year OS rate was 10.7%. The main adverse reactions were bone marrow suppres-sion, nausea/vomiting and alopecia. Other adverse reactions were rarely observed. Conclusion:MAID treatment controls disease progression effectively and the side effects can be tolerated. MAID treatment can be used as one of the first-line chemotherapy regimens for advanced soft tissue sarcoma.